Polish orthopedics and traumatology最新文献

{"title":"Surgical treatment outcomes of proximal humerus fractures including shoulder hemiarthroplasty in patients of the Orthopedics and Trauma Department in Siedlce","authors":"M. Marczuk, M. Płończak","doi":"10.31139/chnriop.2019.84.4.20","DOIUrl":"https://doi.org/10.31139/chnriop.2019.84.4.20","url":null,"abstract":"Proximal humerus fractures constitute 4-5% of all fractures occurring in adults. The aim of the study was to evaluate treatment outcomes for displaced proximal humerus fractures in patients eligible for surgical treatment who were hospitalized in the Orthopedics and Trauma Department of the Ministry of the Interior Hospital in Siedlce between 2016 and 2018. During this period, 153 patients with proximal humerus fractures were treated: 54 men (average age was 54 years) and 99 women (average age was 72 years). Surgical treatment was used in 112 patients. Follow-ups were carried out for 105 operated shoulders: 81 patients treated with intramedullary nailing group IIa, 13 patients treated with fixed-angle plate fixation – group IIb, 10 patients treated with hemiarthroplasty group III and 14 patients treated conservatively group I. The authors evaluated the results based on the functional assessment of the shoulder according to the modified Constant-Murley Score and the occurrence of complications in individual groups. The best outcomes were in the group of patients treated with intramedullary nailing (group IIa) – 49.4% good and very good outcomes, mean CM score of 67 was achieved. In group IIb, the average functional score was 56 points, in group III – 49 points. The worst functional outcomes were recorded in the non-surgical patients (group I), mean CM score of 39 points. As a result of complications, reoperation was necessary in 7 patients treated with internal fixation. Patients treated with hemiarthroplasty did not require revision surgery. The authors state that surgical treatment of displaced proximal humerus fractures gives better outcomes in the early followup period than the conservative treatment; in elderly patients who sustained comminuted fractures of the proximal humerus for which stable internal fixation cannot be performed, shoulder arthroplasty is recommended. According to the authors, none of the surgical methods of treating displaced proximal humerus fractures guarantees regaining full shoulder function.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of dual-articulation prostheses in treating femoral neck fractures – a preliminary report","authors":"M. Smoczyk, M. Płończak","doi":"10.31139/chnriop.2019.84.4.22","DOIUrl":"https://doi.org/10.31139/chnriop.2019.84.4.22","url":null,"abstract":"The authors present their own experience with the use of dual-articulation prostheses in a group of patients with femoral neck fractures. The aim of the study was to assess the possible reduction of the risk of dislocation after hip arthroplasty in a group of patients particularly prone to dislocation, that is patients with traumatic femoral neck fracture [1]. The material included 16 prostheses implanted in 2016-2017. The follow-up period ranged from 18 to 42 months. There were no dislocations in the observed group. In the opinion of the authors, arthroplasty using dual articulation is a well-advised alternative method for total “traditional” arthroplasty and hemiarthroplasty in the treatment of displaced femoral neck fractures.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48963869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous repair of scapholunate and distal radio-ulnar joints instabilities – case report","authors":"Z. Szlosser, A. Żyluk","doi":"10.31139/CHNRIOP.2019.84.3.15","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.3.15","url":null,"abstract":"Simultaneous, serious injury to the scapholunate ligament and triangular fibrocartilage complex, causing symptomatic instability of the SL and DRUJ occurs rarely. In most cases the injury involves only one of these structures, and if both are affected, it usually does not result in symptomatic instability of both. the paper reports a case of simultaneous, symptomatic scapholunate and distal radio-ulnar joints instabilities, requiring operative treatment of both. the repair of both pathologies was performed simultaneously (at one operation), using three-ligament tenodesis (Brunelli/Garcia-elias) for SL joint and radio-ulnar tenodesis (Adams-Berger) for DRUJ. Details of the operative technique were described and illustrated by figures. Final treatment outcome was satisfactory. the authors beleive that simultaneous repair of both instabilities is a good option, allowing for reduction of treatment period. However, it is complicated and challenging operation, requiring high technical skills and experience in wrist surgery.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Types and treatment of distal humerus fractures in children","authors":"Ł. Matuszewski","doi":"10.31139/CHNRIOP.2019.84.3.13","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.3.13","url":null,"abstract":"Introduction. The distal region of the humerus is the most common location of injuries - taking into account the entire humerus of the child. Errors made during their diagnosis and treatment are associated with the occurrence of complications. When analyzing and interpreting x-ray images, one should not forget about the presence of numerous ossification points of this region and the associated temporal variability of their appearance and joining with the epiphysis. Classifications of injuries to that part of the child’s skeletal system used in the past or the Salter-Harris classification applied now, do not reflect the complete morphology of the damage, which is connected with the application of appropriate medical treatment. Aim. The aim of the study is to present the morphology of the most common types of fractures of the distal humerus in children, in relation to age and sex, and to present the required and currently used methods of their treatment along with the outcomes. Materials and methods. The study involved 102 patients aged 4 to 17, hospitalized at the Department of Orthopedics and Pediatric Rehabilitation of the Medical University of Lublin between 2008 and 2016, who were divided into four groups in terms of age. The study group consisted of 72 boys and 30 girls. The analysis covered age, sex and the body side. Results. As a result of the analysis, 6 morphological forms of distal humeral injuries in children were identified. There was no statistical significance between the frequency of fracture and the patient’s sex or the body side. The methods of treatment used were also described. The outcomes were evaluated using the Tempelton-Graham scale. Conclusions. In the fractures of distal humerus, the aim should always be the anatomical reduction of fractures of bone fragments, which allows the recon- struction of the articular surface of the elbow joint and implementation of early rehabilitation of the patient. Knowledge of the morphology of the injury helps to select an effective treatment method. As for operative techniques, and considering the biology of the skeletal system, the stabilization of bone fragments with Kirschner wires seems to be the most effective, after first performing the anatomical open or closed reduction.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48899600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do people with overweight have bigger bones? Body mass index (BMI) and the size of the femoral head","authors":"D. Ciechanowicz, A. Wesołowski, Ł. Kołodziej","doi":"10.31139/CHNRIOP.2019.84.3.14","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.3.14","url":null,"abstract":"Introduction. The study checked whether there is a relationship between an easily accessible parameter like Body mass index BMI and the diameter of the femoral head. Material and methods. the data of 47 consecutively surgically treated patients from the Department of Orthopedics, Traumatology and Oncology of the Motor Mechanism of the Pomeranian Medical University who underwent total hip arthroplasty were analyzed. Patients were divided into two groups: group I – 26 women and group II – 21 men. The diameter of the femoral head was measured intraoperatively with a caliper. Body weight and height were measured the day before the planned surgery. Results. Average age 65.77 (± 13.84) years in women, 65.95 (± 11.61) years in men. Mean BMI 27.57 (± 4.14) in women, 28.86 (± 4.80) in men. In group I (21 men) there was no statistically significant correlation between BMI and femoral head diameter (p = 0.305). However, there was a strong positive correlation (r = 0.6279, p = 0.02) between the height and diameter of the femoral head. In Group II (26 women), a moderately positive correlation (r = 0.4301, p = 0.028) was found between BMI and the diameter of the femoral head. In addition, there was a strong positive correlation between the diameter of the femoral head and height (r = 0.6873, p = 0.0001) and body weight, and the diameter of the femoral head (r = 0.5904, p = 0.01). Conclusions. Men in comparison to women, despite similar mean BMI and age, had statistically significant (p = 0.000003) higher mean size of femoral head – diameter of femoral head in women = 47.65 (± 3.91) and men, 53.19 (± 2.74). Increased BMI suggests that the diameter of the femoral head is also larger, but only in women. However, a more universal parameter is growth because it showed a strong positive correlation with the value of the diameter of the femoral head in both the group of women and men.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avulsion fracture of the tibial insertion of the PCL in child – case report","authors":"Ł. Matuszewski, J. Kałakucki, A. Ciszewski","doi":"10.31139/CHNRIOP.2019.84.3.17","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.3.17","url":null,"abstract":"the posterior cruciate ligament (PcL) plays a relevant role in maintaining proper mechanical stability of the knee joint. Avulsion fracture of the tibial inser- tion of the PcL is a very rare injury in children. Despite of clinical signs, radiologic studies are fundamental for its correct diagnosis and treatment. Its might be treated either conservative or operative. In children population there are not too many scientific studies which circumscribed such injury. therefore, we still do not know what is the most effective treatment for avulsion fracture of tibial insertion of the PcL. the case we describe is a classical avulsion fracture of the tibial insertion of the PcL with accurate diagnosis and the surgical treatment followed by short follow-up control. the lesion was fixed with the screw through an open posterior approach with anatomic reduction. the patient has been closed followed for 6 months with extreme good results such as: stable painless knee and excellent functional outcome.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leri Disease – case report of uncommon disease","authors":"Barbara Igielska-Bela, M. Krzemiński","doi":"10.31139/CHNRIOP.2019.84.3.19","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.3.19","url":null,"abstract":"","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69599218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-implant femoral shaft fracture in patient with healed femoral neck fracture treated operatively using Targon FN system","authors":"J. Poszepczyński, Krzysztof Andrzejewski, R. Grabowski, J. Lesman, M. Majewski, Marcin Domżalsk","doi":"10.31139/CHNRIOP.2019.84.3.18","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.3.18","url":null,"abstract":"Pursuant to the recent literature recommendations, we managed 31B1 fracture with Targon FN plate (BBraun/Aesculap, Germany) in our hospital. Patient reported to our center 14 weeks after operation, complaining about pain ailments in the proximity of the operated area. Patient did not sustain any other injuries. X-ray examination revealed the healed fracture of the femoral neck and fracture below a lower screw stabilizing implant.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexor tendon repair in local infiltration anaesthesia and a bloodless field – case report","authors":"Z. Szlosser, A. Żyluk","doi":"10.31139/CHNRIOP.2019.84.3.16","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.3.16","url":null,"abstract":"Local infiltration anaesthesia with a bloodless operation field allows for proceeding surgery within the hand with no need of use of the tourniquet. this effect is obtained through an injection of greater than standard volume of the anaesthetic solution composed of lignocaine and adrenaline. Adding adrenaline to the mixture induces spasm of small arteries within an infiltration area followed by bleeding inhibition which allows for visualization of most subtle but important structures in the hand and finger. this article reports a case of repair of delayed flexor pollicis longus tendon injury using this method of anaesthesia. A method of finding and retrieval of the flexor pollicis tendon form the wrist to the original point of injury with a drain is also shown. this report shows that local infiltration anaesthesia with adrenaline is an useful technique for repair of acute and delayed tendon injuries, possible to perform by a surgeon himself, with no need of anaesthetist engagement.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign Joint Hypermobility Syndrome","authors":"Krzysztof Pietrzak","doi":"10.31139/CHNRIOP.2019.84.2.12","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2019.84.2.12","url":null,"abstract":"Benign joint hypermobility syndrome is a condition in which joint laxity causes clinical symptoms, mainly pain. The diagnostic process is based on physical examination. There is no specific treatment. Symptomatic treatment involves mainly physical therapy and psychotherapy. Considering the psychological impact of the symptoms BJHS patients need targeted multidisciplinary treatment. As the syndrome is chronic, and symptoms affect many sites, patients are often dismissed, which is caused in particular by insufficient awareness of the disease.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}